ResumeUpd02-16-16

Confidential Resume of 1140 Providence PlaceDIANE A. CARR, RHIA Decatur, GA 30033

Home: 404.417.0909 • Cell: 678.427.3398 • Email: [email protected]

HEALTH INFORMATION MANAGEMENT

STATE-OF-THE-ART KNOWLEDGE AND PROGRESSIVE ACCOMPLISHMENT IN DIRECTING / COORDINATING HEALTH INFORMATION PROJECTS TOWARD THE COMPUTER-BASED PATIENT RECORD (ELECTRONIC DOCUMENT IMAGING). EXPERTISE IN IMPLEMENTATION OF COMPUTERIZED HEALTH INFORMATION SYSTEMS, HEALTH INFORMATION OPERATIONS AND CLIENT SERVICES. __

PROFILE

Management Performer: Outstanding track record for successful reorganization of HIM departments, to include document management, chart management systems, CM programs; reengineering of departmental procedures for new MS-DRG/OPPS reimbursement structure implementation and the JC surveys; development of effective training programs for all levels/systems.

Effective Team Builder: As Director of HIM/Privacy Officer, sustained consistent staffing levels and boosted productivity through rising quantity and quality of services by creating quality and productivity indicators for all functions of the department; and by launching training programs that created a sophisticated, knowledgeable, flexible workforce with high morale and retention rates.

Articulate, Engaging Communicator: Effective communication in vendor to client interactions as well as within the HIM environment. Skillfully translate CMS regulations at Senior Management level personnel. Deliver effective succinct presentations to major clients. Experienced in establishing effective priorities; formulating criteria; and executing programs that increase organization, productivity, efficiency and profits.

Technical Proficiency: Extensive knowledge of HIM/PA/PM applications; electronic document management (EDMS) systems: McKesson’s HPF, Streamline Health, Hyland OnBase. Proficient in client / server technology: Siemens, Meditech. Extensive knowledge of EHR systems: Epic, Soarian, Cerner; proficient with EHR implementation build, graphical user interface (GUI) development. Windows 7/XP, MS Office _________

PROFESSIONAL EXPERIENCEHarmony Health Solutions, Inc. Tampa, Florida

Interim Coding Manager, Level II Trauma Center – E. Texas 01/2015 – Present

Oversaw and managed Health System coding for 4 facilities; Provides daily leadership to staff of 24 – 26 Coders and two Lead Coders serving 4 hospitals; Oversees ED charge posting of Injections/Infusions and E/M leveling for facility/pro fee; Wrote and maintains P/P for Health System coding Led ICD-10 educational training prior to implementation; continued education through January 2016 Consistently meets Revenue Cycle pre-established metrics Continue to maintain DNB ~ $2.5 - $5.0 MN during transition and increased workload Provides daily Coder education and feedback to individual Coders as appropriate Works collaboratively with CDI team; provides daily feedback on mismatches for reconciliation Utilizes 3M 360 reporting to monitor Coder quality and productivity Provides Quality Management support of Core Measures Provides Coder evaluations; encourages furthering education to broaden coding skills

Harmony Health Solutions, Inc. Tampa, FloridaInterim Coding/CDI Manager, Level II Trauma Center – E. Texas 12/2013 – 01/2015

Level II Trauma center – East Texas HIM Liaison/Coordinator & Site Admin for implementation of 3M 360 Encompass(360e), including

(CAC, CDIS, & Quality Analytics) – Go-live 8/2014 Manage staff of 30 employees, including TMF employees and Contract Coders

Confidential 5/3/2023

mailto:[email protected]



Manage daily Coding/CDI activities, including Epic WQ assignments, scheduling, 360e troubleshooting, Coder assistance

Chart reviews for Quality Management/Core Measures on questionable accounts for coding accuracy

Provides leadership, education, training, and cross-training of 30 CDS and Coders Oversee Coder/CDS ICD-10 education Maintains DNB at ~$1.5 MN - $3.0 MN(from est. high of ~$30 mn); assignment of Epic WQs based

upon staffing/workload Review insurance payer revisions/denials for appeal opportunities; provides Coder/CDS education

where appropriate. Responsible for weekly/monthly 360e/Epic reporting to senior leadership; also provides ad hoc

reporting ICD-10 Readiness – Daily Coder education; dual coding, and contract Coder management

Harmony Healthcare, Inc. Tampa, FloridaInterim HIM Director, Integrated Health Network, NV 05/2012 – 09/ 2013

Provided direction/management of HIM activities for 946-bed Integrated Health Network, including

Level II Trauma center, community acute care hospital; Rehabilitation, and Skilled Nursing facilities Managed $7.2 million budget Managed Hybrid health record - Epic EHR & 3M Coding & Reimbursement system Cleared 1.5-years backlogs, including Birth Certificate, Chart Analysis, & ED/CDU processing Oversaw medical record clean-up of ~16,000 temporary folder backlog Fosters good relations between Coders and Clinical Documentation Improvement Specialists Oversaw transition from traditional dictation/transcription system to back-end speech recognition

(BESR) system Eliminated use of ER coding vendor – cost savings Implemented remote Outpatient coding – cost savings Reduced DNFB from $60 mn to $3 - $5 million; consistently maintained in this range Spearheaded HIM Steering Committee for IHN – Drafted Charter ICD-10 preparation ongoing – Oversaw Optum online Coder education program Launched and planned CAC system implementation; build of data dictionaries, testing, and User

Acceptance Testing (UAT) Chairs HIM Steering sub-committee on attaining complete EHR Developed and maintains excellent physician relations – Department and MEC participation Member of Crimson (Physician Profiling system) Steering Committee Restored positive IHN HIM image Planned and launched implementation; oversaw training of Hyland OnBase Scanning/Indexing to

eliminate hybrid record Fostered excellent communications and interpersonal relations intra- and inter-departmentally

throughout IHN

On Assignment HIM, Inc. San Diego, CaliforniaInterim Coding Manager 01/2012 – 5/2012

Responsible for establishing and maintaining hospital-wide coding policies/procedures in regional Children’s Hospital

Assessing Coder’s readiness for ICD-10 Building team confidence in preparation for ICD-10; working with HIM Director to foster positive

attitudes and strong, inter-relationships ICD-10 Preparation: Collaborating with HIM Director to implement Anatomy/Physiology training in

March





KForce Healthcare, Inc. Tampa, Florida Interim Director of Coding 07/2011 – 01/2012

Integral to hospital-wide ICD-10 implementation process Assessed coding department’s ICD-10 readiness and Initiated Coding Department ICD-10 training,

including A & P, Disease Pathology, Medical Terminology Collaborated with ICD-10 Project Manager to assess, educate, & train appropriate medical staff &

hospital staff Centralized coding – responsible for hospital-wide coding Maintained DNFB at required or less than 2 days revenue target Established and maintained departmental and hospital-wide coding policies & coding standards in

regional acute care facility Integral to Revenue Cycle committee Reduced DNFB from average of $9 – $11 million to average of $2.5 million; consistently maintained Re-organized departmental workflow to achieve maximum productivity Compliance management – ongoing

3M Health Information Systems, Inc. Atlanta, GeorgiaSenior Inpatient Consultant 04/2010 – 07/2011

Earned AHIMA’s ICD-10-CM/PCS Trainer Certificate – October 2010; recertified June 2011

Completed “AHIMA Academy for ICD-10 Trainers: Building Expert Trainers in Diagnosis and Procedure Coding”

Performed DRG Assurance Program (CDIP) Assessments and Program implementations, including comparisons/contrasts between ICD-9-CM and ICD-10-CM/PCS during MDC presentations

Performs client DRG and Coding Validations Assists in annual CMS updating of Student Training Manual updates as appropriate

WellStar Health System Marietta, Georgia Director, Enterprise Coding Services 04/2009 – 03/2010

Assessed coding staff for ICD-10 readiness and early training needs Prepared ICD-10 Coder Training calendar & timeline through 04/01/14; sent Coder Educator to

AHIMA’s ICD-10 Boot Camp Provided coding leadership and direction to 48.50 FTEs, including 2 supervisors, quality manager, &

Coder Educator Proficiently managed DNFB – reduced from $27 (peak) million to $2.5 million (lowest level) Facilitated implementation of 3M’s Clinical Documentation Improvement Program Conducted quarterly Coder educational roundtables across all patient types Developed Coding Compliance policy & Physician Clarification policy/Revised IP Coding Guidelines Efficiently managed $2.5 million budget

Maxim Health Information Services Beachwood, Ohio Interim Coding Manager 06/2008 – 03/2009

Stanford University – Engaged to provide assessment of Coding Department St. Francis Medical Center - Engaged to manage 13 IP/OP Coders, reduce ~$9 million DNFB, and

streamline processes to increase productivity – DNFB currently at $1.8 million Oversaw hospital-wide coding/ rejections & errors, status changes, and combined billing process Provided Coder/CDS education/training – monthly requirement Redesigned Physician Clarification policy/procedures; advised & educated CDS staff on appropriate

physician queries Facilitated weekly status meetings with CDSs/Coders to facilitate JAT Clinical Documentation

Management ProgramConfidential 5/3/2023



Home: 404.417.0909 • Cell: 678.427.3398 • Email: [email protected] Spearheaded documentation education to Hospitalists, ARNPs, PAs, and CNS’

Compliance management: develops site-specific policies/procedures consistent with Health System’s goals & objectives; works closely with Reimbursement Director to achieve goals

Communicates coding guidelines effectively to appropriate executives/managers to maintain coding compliance and consistency throughout organization

Interim Director/Privacy Officer

Muskogee Regional Medical Center/Capella Healthcare Reduced DNFB from >$9 million to $125,000 in 3 months Eliminated substantial backlog in assembly/analysis (over one thousand incomplete/delinquent

records Maintained monthly coding compliance consistent with corporate goals and objectives Maintained coding current and within 4-day bill hold Re-organized A/A process to clean up backlog due to implementation of 2 major departmental

systems simultaneously Re-organized transcription process to better accommodate physicians and patient care; re-

negotiated contractual TAT consistent with current best practices & national guidelines

Rockdale Medical Center, Inc. Conyers, Georgia Director HIM Services/Privacy Officer 07/2004 – 06/2008

Proficient knowledge of CMS’ MS-DRG/OPPS reimbursement changes; ongoing education & training provided to MEC, Coders, peers, and Administration

Implemented Clinical Documentation Management Program (CDMP) to strategically manage MS-DRGs

Proficient Revenue Cycle Management – Effectively Manages Coding/DNFB within 4 bill-hold days Consistently maintains DNFB; average DNFB is $250k or less; RMC target is $500k Accounts Receivable days: 36 – 41 Manage Business Office coding corrections/rejections within 24 hours; ICD-9-CM/CPT/HCPCS Business Process Redesign – Designed and managed physical move of HIM department

Perot Systems Corporation Plano, Texas Senior Business Manager Consultant 2003 – 2005

Billable 95% on various engagements: Engaged to assess HIM departments; Implemented recommendations Project Management; HIM IT Liaison; Application testing; Defined interface specifications Participated in hospital-wide system implementation JC Preparation Business Process Redesign; facilitated & encouraged effective communications for project success Guided clients in new & replacement product evaluation & selection Assisted with sales activities

HealthLink, Incorporated (Now IBM) Houston, Texas Senior Management Consultant – PHHS, Dallas, TX 2001 – 2003

Interim Senior Associate Director & QuadraMed Project Manager of Health Information Mgmt.

ASC (formerly Superior Consultant Holdings Corporation, Inc.) Southfield, Michigan Senior Management Consultant 1999 – 2001

Quovadx Corporation, Inc. (Formerly HCDC) Marietta, Georgia Project Management Consultant 1998 – 1999

Streamline Health (formerly LanVision, Inc.) Cincinnati, Ohio





Client Executive 1996 – 1998

McKesson (formerly HBO & Company) Atlanta, Georgia Account Executive 1986 – 1996

EDUCATION

BACHELOR OF MEDICAL SCIENCE - EMORY University School of Medicine - Atlanta, Georgia 1980Major: Health Record Information Management • Minor: Information Systems Technology• HIM internship at large, Metropolitan County Hospital

PROFESSIONAL AFFILIATIONS

Member: American Health Information Management AssociationsMember: Association of Clinical Documentation Improvement SpecialistsMember: National Association for Healthcare Quality

Member: Healthcare Financial Management AssociationPresident: Greater Atlanta Medical Record Association, 1984 - 1985Chairperson: Membership Committee - Georgia Medical Record Association, 1986Chairperson: DRG Task Force - Greater Atlanta Medical Record Association, 1986

REFERENCES & FURTHER DATA AVAILABLE UPON REQUEST



ResumeUpd02-16-16

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